Provider Demographics
NPI:1154724235
Name:CHEN, YUN (FNP-C)
Entity type:Individual
Prefix:
First Name:YUN
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:
Other - Last Name:CHEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-C
Mailing Address - Street 1:2910 N 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-4434
Mailing Address - Country:US
Mailing Address - Phone:602-406-3112
Mailing Address - Fax:602-294-8269
Practice Address - Street 1:485 S DOBSON RD
Practice Address - Street 2:SUITE 101
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-5602
Practice Address - Country:US
Practice Address - Phone:602-406-3112
Practice Address - Fax:602-294-8269
Is Sole Proprietor?:No
Enumeration Date:2014-10-02
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP7350363LF0000X
AZRN164153163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ954534Medicaid
AZZ171293Medicare PIN